Asians who immigrated to U.S. before age 25 have poorer mental health than older immigrants

Asian-American immigrants who came to the United States before they were 25 years old have poorer mental health than their compatriots who came to this country when they were 25 or older, according to data from the first national mental health survey of Asian-Americans.

The study is noteworthy because it shows that using traditional measures of socio-economic status -- number of years of school and household income -- to predict health outcomes is not accurate for individuals who immigrate when they are children or young adults, according to Janxin Leu, a University of Washington assistant professor of psychology and lead author of the study.

Immigrants who arrived in the U.S. before they were 25 attained higher levels of education and income than did older immigrants. However, 13 percent of the younger immigrants reported symptoms of an anxiety or depressive disorder in the previous 12 months compared to 9 percent of the over-25 group.

Leu and the other researchers found that what is called subjective social status was more accurate in predicting mental health outcomes than income or education. To calculate this, they told the people surveyed to imagine a ladder with 10 rungs containing individuals who had achieved the most on the top rung and those who were least successful on the bottom. Then they were asked to place themselves on the ladder in comparison with other people.

“The under-25 group experiences a lot of stress, the so called ‘long-reach of childhood’ that comes at a formative time of development,” she said. "As adults, the under-25 group is doing better with English language skills and has higher levels of education and income, but it is experiencing more disease as adults. Early stressors are overcoming gains in income and education later in life.

“It is important to understand the early development of mental health. Children who are bullied because they are immigrants, for example, may suffer long-term mental health consequences.”

The survey included data from more than 1,400 foreign-born Asian-Americans who were at least 25 years of age. Chinese (32 percent), Filipinos (20 percent) and Vietnamese (16 percent) were the three largest ethnic groups in the survey. Leu said the age of 25 was used as a marker to distinguish between immigrants who experienced disruption during their formative childhood, adolescent and early adult years and those who did not. Recent evidence has suggested that human social and cognitive development reaches maturation around the age of 25.

Age at immigration ranged from less than 1 year to 82 years. Forty-two percent of the participants immigrated before they were 25, and 58 percent arrived at age 25 or later.

Leu said studying Asian-American immigrants is important in understanding the development of American children because nearly one-quarter of U.S. children under the age of 6 are immigrants or have parents who were immigrants.

“The definition of who is an American is changing, and as this wave of people becomes part of the U.S. it will impact the country’s health care system. We need to prevent disease and promote mental health. A little prevention goes a long way. Immigrants are one group where we can’t ignore the developmental context of mental health problems.”

The study was funded by the Robert Wood Johnson Foundation and the National Institute of Mental Health and published in the journal Social Science & Medicine. Co-authors of the paper are David Takeuchi, a UW professor of social work; Emily Walton, a UW sociology doctoral student; and University of California, San Francisco, professors Irene Yen, Stuart Gansky and Nancy Adler.